Monday, December 28, 2009

Every January, Apple founder and chief executive officer Steve Jobs takes to a San Francisco stage and unveils the company's innovations to adoring Mac fans - be it iTunes, a better iPod or an impossibly skinny laptop.

This year, he stole the show with a different message: I'm sick - but not that sick.

In a public letter released yesterday, Mr. Jobs said a hormone imbalance is to blame for the weight loss that had prompted months of speculation about his health - and gyrations in Apple's stock.

Mr. Jobs, a 53-year-old pancreatic cancer survivor, said that his thinness had been a mystery even to his doctors until a few weeks ago, when "sophisticated blood tests" determined it was because of "a hormone imbalance that has been 'robbing' me of the proteins my body needs to be healthy." The announcement had diehard Apple consumers buzzing at the Macworld Conference & Expo in San Francisco, where Mr. Jobs had been expected to give his annual keynote speech today.

But his company announced last month that for the first time in more than a decade its CEO would be passing the reigns to Apple marketing executive Philip Schiller.

That only exacerbated rumours that all was not well with Mr. Jobs, who appeared gaunt at public appearances earlier in 2008. One false Internet report said he had suffered a heart attack; others speculated he was on his deathbed.

While the notoriously private Mr. Jobs offered few details about his hormonal condition, he said he was being treated with a simple nutritional regimen and expected to gain his weight back by the spring.

George Fantus, an endocrinologist at Mount Sinai Hospital in Toronto, says many hormonal conditions can cause weight loss, including hyperthyroidism.

But there are also a number of hormonal deficiencies faced by people with pancreatic problems, such as Mr. Jobs, who announced in 2004 that he had undergone successful surgery to treat a very rare form of pancreatic cancer - an islet cell neuroendocrine tumour. The cancer is easily cured if diagnosed early.

The pancreas contains islet cells, which make the hormones insulin and glucagon, helping to regulate blood sugar levels, said Dr. Fantus, professor of medicine and physiology at University of Toronto.

Often surgery for pancreatic cancer removes a very large chunk, if not all, of the pancreas, leading to a deficiency in the sugar-regulating hormones, he said.

"We often have people developing diabetes after that," he said. "If you have diabetes that's not treated, you'll lose weight."

The pancreas also excretes enzymes that aid the digestion of fats, proteins and sugars.

"So if you're short these enzymes, you will malabsorb your food and you'll lose weight," Dr. Fantus said. Diabetes is treatable, and enzyme deficiencies can be treated with enzyme replacement pills, Dr. Fantus said.

Yesterday's announcement isn't likely to end the speculation about Mr. Jobs's health.

Almost 50,000 attendees are expected at this week's Macworld, the largest annual gathering of Mac enthusiasts and Apple industry types.

"It was a big letdown to hear that Steve wasn't giving the keynote," said John Strikwerda, a Kitchener, Ont., resident who runs the blog ehMac.ca. "For many Mac geeks like myself, the Steve keynote was almost (or more) exciting as Christmas," he said in an e-mail.

When Mr. Jobs's letter popped up in Mr. Strikwerda's inbox, he said his immediate reaction was fear for Mr. Jobs's health - then relief that Mr. Jobs is "apparently doing okay." But he heard other reactions from attendees.

Apple's shares rose by more than 3.5 per cent after the letter was released, so "one theory was that Steve did this to raise the stock price today, to balance the hit that it might take tomorrow [if there weren't any exciting announcements from the company]," he said.

"The other theory was that the letter sounded funny that a billionaire would have a hard time finding a doctor to diagnose his issue and maybe this was a bit of a stall tactic."

More details are unlikely to be forthcoming from Mr. Jobs, who founded Apple with engineer Steve Wozniak after dropping out of college.

Mr. Jobs left the company in 1985 after an internal power struggle. He returned in 1996 and is credited with reversing Apple's fortunes by launching the iPod MP3 player and the iPhone.

In the signoff, Mr. Jobs wrote: "So now I've said more than I wanted to say, and all that I'm going to say about this."